Provider Demographics
NPI:1275059750
Name:DJOKOTO, OLIVIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:
Last Name:DJOKOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 E 184TH ST APT M
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-7730
Mailing Address - Country:US
Mailing Address - Phone:347-575-9751
Mailing Address - Fax:
Practice Address - Street 1:814 E 233RD ST FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3204
Practice Address - Country:US
Practice Address - Phone:718-519-7672
Practice Address - Fax:718-701-8325
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720857-1163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical